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Originally Posted by Flames Fan, Ph.D.
Regarding your first point: this is the fantasy basis that a lot of the "stem" or precursor cell labs subscribe to. Biggest question: why would the cells differentiate in this manner? People propose this type of thing in the heart world as well, but never describe the differentiation process (and the requisite cues) that the cells will undergo.
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I think you're confusing your stem cells. Hematopoietic stem cells (HSC - generally from bone marrow) differentiate into lymphocytes (in addition to erythrocytes and some other cell types). It's well-defined; in fact it's how bone marrow transplants for people suffering from leukemias and lymphomas work. We differentiate these cells every day in our lab. These are not the "embryonic" or "adult" stem cells that you might be thinking -- do you mean stems cells that will differentiate into cardiomyoctes? Or something like that? (I don't know, I'm not a cardiac or muscle person). I share some of your cynicism about these miracle stem cell cures. HSCs are different...
MS is generally due to autoreactive CD4+ T cells that attack myelin. They are conditioned this way by antigen-presenting macrophages and dendritic cells that somehow present myelin proteins to naive T cells. The concept of this research is that ablation of the T cells will kill all the autoreactive T cells (in addition to macrophages and DCs that are presenting myelin as an antigen), then transplantation of the HSC will then allow the patient to generate new T cells that are non-reactive. This is a regularly performed technique in mice.
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As for the control arm... they're mandatory in some shape or form. Otherwise, how do you know what the activity of the cell treatment is? Even in terminal cancers they'll often run a best supportive care arm, which is effectively nothing better than a placebo.
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Fair enough, I don't know anything about clinical trials. This is also a fairly small patient group as well. We're so far from the clinic in our lab! All I said is that there is no way any ethics board would permit immuosupression without some sort of EFFECTIVE treatment (and best standard of care) to replace their lymphocytes (e.g. antibiotics or something significant). People would die of infections as a control - hardly ethical!
MS sucks. Anything we can do to ameliorate people's lives is positive. Donate to the MS Society - they don't just support research like ours, they also fund life-improvements for people suffering from MS.
ETA: this treatment is actually quite well-studied. THere is a fairly significant review on the topic:
http://www.ncbi.nlm.nih.gov/pubmed/23192675
Properly controlled studies have also been discussed as a key goal of these multi-centre trials:
http://www.ncbi.nlm.nih.gov/pubmed/22383228